The causes for alcohol abuse and dependence cannot be easily explained. It is often seen as a “disease of affluence”, being uncommon among indigenous people until they were colonized. Today, alcohol abuse and alcoholism are a major health problem particularly in the western world, but increasingly also in the so-called developing countries.Alcoholism is a life-threatening problem that often ends in death, particularly through liver pancreatic or kidney disease, internal bleeding, brain deterioration,

alcohol poisoning and suicide. As well, alcoholism is a major contributing factor for motor vehicle accidents, violence and assaults, as well as a leading cause of neurological and other medical problems (e. g. cirrhosis, etc.).

Alcohol dependence can be harder to break and significantly more damaging than dependence on most other addictive substances. The physical symptoms when withdrawing from alcohol are seen to be equal to those experienced during withdrawal from heroin.

Long-term abusers of alcohol can suffer delirium tremens (DT)

Medical Effects

The long-term effects of alcohol dependency include:

Pancreatitis, or inflammation of the pancreas

Heart disease, including coronary artery disease

Neuropathy, or damage to the nerves

Bleeding esophageal varices, or enlarged veins in the tube that connects the esophagus to the stomach

Brain degeneration and alcoholic neuropathycirrhosis of the liver, a chronic disease that causes destruction of liver cells and loss of liver function

Depression, insomnia, anxiety, and suicide

High blood pressure

Increased incidence of many types of cancer, including breast cancer

Nutritional deficiencies

Wernicke-Korsakoff syndrome, a neuropsychiatric disorder caused by thiamine deficiency that results from poor nutrition in alcoholics

Significant damage to occupational, social and interpersonal areas, including sexual dysfunction

Social Impact

The social problems arising from alcoholism can include loss of employment, financial problems, marital conflict and divorce, convictions for crimes such as drunk driving or public disorder, loss of accommodation, and loss of respect from others who may see the problem as self-inflicted and easily avoided. Exhaustive studies show that alcoholism affects not only the addicted person, but can profoundly impact the family members around them. Many people incorrectly assume that once an alcoholic stops drinking, all is well. However, many people who have stopped drinking still refer to themselves as “alcoholics” or “recovering alcoholics”.

Alcohol Politics and Public Health

As alcohol problems affect the whole society, it is part of the political responsibility of government and parliaments to build up an alcohol policy in order to reduce the harm caused by alcohol consumption. Alcohol politics are a rather unbeloved theme, because very often the behaviour of consumers, economic interests or simply the social reality is a hindrance for an objective approach and way of acting. As best measures to reduce alcohol consumption, scientific research has found price increase through taxation, availability (fewer point of sales) and the ban on advertising. Educational prevention has shown to be only effective by raising the knowledge and perhaps the readiness to accept higher prices.The alcohol industry, however, is well organized and lobbying all over the world to undermine efforts towards the development of effective programmes against the harmful effects of alcohol consumption.They now concentrate their expansion and promotions towards the developing countries as sales in industrial countries have stopped growing.The tragedy is that those countries are not equipped to fight against alcohol problems, and there is little social network to help the families and the alcoholic.